Heart failure in advanced chronic kidney disease: treatment rationale

Herzinsuffizienz bei fortgeschrittener Niereninsuffizienz: Grundprinzip der Behandlung


Patients with chronic kidney disease (CKD) exhibit an increased risk to develop heart failure and the presence of heart failure in patients with CKD leads to a worse prognosis. The following overview article summarizes the current standard of medical heart failure therapy and discusses the treatment characteristics in patients with CKD.


Patienten mit chronischer Niereninsuffizienz weisen ein erhöhtes Risiko auf, eine Herzinsuffizienz zu entwickeln, und das Vorliegen einer Herzinsuffizienz bei Patienten mit chronischer Niereninsuffizienz führt zur Verschlechterung der Prognose. In der vorliegenden Übersichtsarbeit wird der derzeitige Standard der medizinischen Therapie bei Herzinsuffizienz zusammengefasst dargestellt. Außerdem werden die Charakteristika der Behandlung von Patienten mit chronischer Niereninsuffizienz erörtert.

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NM and JF are supported by the Deutsche Forschungsgemeinschaft (German Research Foundation; TRR 219; Project-ID 322900939 [C01, M01, M03, M05]).

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Correspondence to Prof. N. Marx MD, FESC, FAHA.

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Conflict of interest

N. Marx has received support for clinical trial leadership from Boehringer Ingelheim, Novo Nordisk, served as a consultant to Boehringer Ingelheim, Merck, Novo Nordisk, AstraZeneca, BMS, received grant support from Boehringer Ingelheim, Merck, Novo Nordisk, and served as a speaker for Boehringer Ingelheim, Merck, Novo Nordisk, Lilly, BMS, and Astra Zeneca. N. Marx declines all personal compensation from pharma or device companies. J. Floege served as a consultant to Astellas, AstraZeneca, Bayer, Boehringer Ingelheim, Novartis, and Novo Nordisk.

For this article no studies with human participants or animals were performed by any of the authors. All studies performed were in accordance with the ethical standards indicated in each case.

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Marx, N., Floege, J. Heart failure in advanced chronic kidney disease: treatment rationale. Herz (2021). https://doi.org/10.1007/s00059-021-05024-3

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  • Renal insufficiency, chronic
  • Angiotensin-converting enzyme inhibitors
  • Beta-blockers
  • Angiotensin receptor-neprilysin inhibitor
  • SGLT2 inhibitors


  • Chronische Niereninsuffizienz
  • Angiotensin-Converting-Enzym-Hemmer
  • Betablocker
  • Angiotensin-Rezeptor-Neprilysin-Inhibitor
  • SGLT2-Inhibitoren